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Case Reports
. 2024 Dec 1;31(12):7625-7630.
doi: 10.3390/curroncol31120562.

Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy for Non-Small Cell Lung Cancer Using Varian Ethos Therapy System

Vanda Leipold  1   2 , Blanka Jakšić  1   3 , Asmir Avdičević  1 , Domagoj Kosmina  1 , Hrvoje Kaučić  1 , Ivana Alerić  1   2 , Karla Schwarz  3 , Mihaela Mlinarić  1 , Giovanni Ursi  1 , Adlan Čehobašić  1 , Dragan Schwarz  1   2   4
Affiliations
Case Reports

Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy for Non-Small Cell Lung Cancer Using Varian Ethos Therapy System

Vanda Leipold et al. Curr Oncol. .

Abstract

We present a patient treated with personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) for non-small cell lung cancer (NSCLC) using the adaptive Varian Ethos™ system equipped with the novel HyperSight imaging platform. Three pulses of 12 Gy were separated by a pause of four weeks during which the tumor was given enough time to respond to treatment. Only initial planning computed tomography (CT) was acquired on a CT simulator (Siemens Somatom Definition Edge), whereas other pulses were adapted using online cone beam computed tomography (CBCT) images (iCBCT Acuros reconstruction) acquired while the patient was lying on the treatment couch and delivered immediately. Significant tumor reduction was achieved between pulses, resulting in improved organs-at-risk sparing. In addition, the on-couch plan optimization based on CBCT greatly reduced the patient's stay at the clinic and the duration of treatment preparation.

Keywords: HyperSight; NSCLC; Varian Ethos; adaptive radiotherapy; personalized ultra-fractionated stereotactic adaptive radiotherapy.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The study received no external funding.

Figures

Figure 1
Figure 1
Comparison of dose distributions delivered during the first, second, and third pulses: (a) dose distribution delivered based on cone beam computed tomography (CBCT) images acquired during the first pulse; (b) dose distribution delivered based on the CBCT image acquired during the second pulse, four weeks after first pulse; (c) dose distribution delivered based on the CBCT image acquired during the third pulse, eight weeks after the first pulse. A substantial reduction in lesion size and dose to the surrounding tissue can be seen.
See this image and copyright information in PMC

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